Bicompartmental knee arthroplasty of the patellofemoral and medial compartments

Abstract

Studies have shown that after total knee arthroplasty neither normal biomechanics nor function is obtained. Selective resurfacing of diseased compartments could be a solution. A narrative review of the available literature on bicompartmental arthroplasty is presented. A literature review of all peer reviewed published articles on bicompartmental arthroplasty of the knee was performed. Bicompartmental arthroplasty is by definition the replacement of the tibiofemoral and the patellofemoral joint. It can be performed with a modular unlinked or a monolithic femoral component. Bicompartmental arthroplasty performed with modular components obtains good to excellent results at ± 10 years follow-up. Function and biomechanics are superior to total knee arthroplasty. Modern monolithic femoral components are reported to give early failure and high revision rates and should be avoided. Modular bicompartmental arthroplasty is an excellent alternative to treat bicompartmental arthritis of the knee leading to good functional results and superior biomechanics in well-selected patients. Caution is needed since only a few peer reviewed articles with small series and old implant designs are available on this type of arthritis treatment. Survivorship in these studies is inferior to total knee arthroplasty.